CPT 11056
Global 000Parng/cutg b9 hyprkr les 2-4
CPT 11056 Billing & Documentation Guide
CPT code 11056 (Parng/cutg b9 hyprkr les 2-4) is classified under Anesthesia with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.49, a non-facility practice expense RVU of 1.9, and a malpractice RVU of 0.04, a total non-facility RVU of 2.43 and facility RVU of 0.59. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $84.07, though rates vary from $71.57 to $110.39 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 11056, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 11056 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Restricted coverage (special situations)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 11056 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 11056
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.49 | 0.49 |
| Practice Expense RVU | 1.9 | 0.06 |
| Malpractice RVU | 0.04 | 0.04 |
| Total RVU | 2.43 | 0.59 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 11056
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $92.77 | $20.05 | $86.91 - $110.39 | 29 |
| Florida | $82.64 | $20.98 | $79.04 - $85.81 | 3 |
| Georgia | $78.54 | $19.91 | $74.57 - $82.5 | 2 |
| Illinois | $80.3 | $20.91 | $76.4 - $84.02 | 4 |
| Michigan | $77.84 | $20.13 | $75.82 - $79.86 | 2 |
| North Carolina | $76.43 | $19.09 | $76.43 - $76.43 | 1 |
| New York | $89.76 | $21.19 | $77.59 - $95.35 | 5 |
| Ohio | $75.65 | $19.54 | $75.65 - $75.65 | 1 |
| Pennsylvania | $80.1 | $19.91 | $75.89 - $84.32 | 2 |
| Texas | $80.18 | $19.67 | $75.36 - $84.73 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 11056
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 11056 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01995 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0905T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 11056
What does CPT code 11056 mean? +
CPT code 11056 represents: Parng/cutg b9 hyprkr les 2-4. It's in the Anesthesia category with a global period of 000.
What is the Medicare reimbursement for CPT 11056? +
The 2026 Medicare national average non-facility payment for CPT 11056 is $84.07. Rates range from $71.57 to $110.39 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 11056? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 11056? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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